By: Kathleen Gaines, MSN, BA, RN, CBC
Psychiatric Nurse Practitioners also known as Psychiatric Mental Health Nurse Practitioners (PMHNPs) are Advanced Practice Registered Nurses that specialize in the mental health needs of adults, children, families, groups, and/or communities. They focus on helping individuals cope with different psychiatric disorders and illnesses as well as help people with substance abuse disorders. In this guide, we’ll explain what a Psychiatric Nurse Practitioner does, how much they make, how to become one, and more.
Part One What is a Psychiatric Nurse Practitioner?
Psychiatric Nurse Practitioners are nurse practitioners that specialize in the treatment of mental health. They assess and diagnose patients suffering from mental illnesses, disorders, and substance abuse problems. They are involved in psychotherapy, can prescribe medication, educate patients and families about their diagnosis, and manage their treatment plans.
Part Two What Do Psychiatric Nurse Practitioners Do?
Psychiatric NPs take care of patients suffering from a variety of mental illnesses and disorders. Their duties will vary based on where they work, but they often include:
- Diagnosing and treating common acute psychiatric problems, illness, and crises
- Psychopharmacologic management in collaboration with a psychiatrist
- Providing individual, group, and family psychotherapy
- Caring for and counseling clients with common identified chronic psychiatric conditions
- Coordinating and integrating multidisciplinary services for clients with complex psychiatric problems
- Monitoring common health care problems and referring to specialized medical treatment as needed
- Providing comprehensive family psychiatric-mental health education
- Performing or recommending age-appropriate screening procedures
- Promoting wellness-oriented self-care
- Being an advocate for family psychiatric-mental health clients and their families
Illnesses and Disorders that Psychiatric Nurse Practitioners Treat
Psychiatric nurse practitioners treat a wide variety of mental illnesses and disorders including:
- Bipolar, manic-depressive states
- Eating disorders
- Obsessive-Compulsive Disorder
- Attention deficit hyperactivity disorder
- Substance abuse
- Panic Disorders
- Autism Spectrum Disorder
- Personality disorders
- Trauma, PTSD, adjustment disorders
Part Three Where Do Psychiatric Nurse Practitioners Work?
Psychiatric Mental Health Nurse Practitioners can work in a variety of locations. These include:
- Community Mental Health Centers (urban and rural)
- Consulting with businesses and communities
- Correctional Facilities
- Domestic Violence Shelters
- Government Agency
- Home Health Agencies
- In-patient Psychiatric Facilities
- Primary Healthcare Clinics
- Private Psychiatric Practices
- Psychopharmacology Clinic
- Psychiatric Consult Services
- Public health agencies
- Residential Substance Abuse Facilities
- State Psychiatric Facilities
- Student Health Clinics
- Urban Nurse-Managed Clinic
- Veterans Administration Psychiatric Facilities
Part Four Psychiatric Nurse Practitioner Salary
As with other types of nurse practitioners Psychiatric NPS can expect to earn salaries on the higher end of the spectrum. According to the Bureau of Labor Statistics, the median pay for nurse practitioners in 2019 was $115,800 per year, or $55.67 per hour. However, the BLS does not differentiate between different types of Nurse Practitioners. According to Payscale.com, Psychiatric NPs make an average of $107,309 per year, as of June 2020. Glassdoor.com reports a slightly higher average annual salary of $110,076.
Psychiatric NPs can earn a higher annual salary with increased years of experience, however:
- 1-4 years of experience earn an average salary of $103,957
- 5-9 years of experience earns an average salary of $109,733
- 10-19 years of experience earns an average salary of $117,150
- 20+ years of experience earns an average salary of $114,214
Currently, the highest paying states for Psychiatric NPs that have reported salaries, according to Payscale.com are as follows:
- Los Angeles, California - $ 130,990
- New York, New York - $118,138
- Boston, Massachusetts - $117,483
- Dallas, Texas - $113,572
Regardless of workplace setting, full-time and part-time nurses enjoy similar benefits. While actual benefits may vary depending on the institution most include the following:
- Health insurance
- Certification Reimbursement
- Retirement Options
- Holiday Pay
- Family Leave of Absence
- Maternity Leave
- Dental Insurance
- Dependent health insurance coverage
- Life Insurance
- Paid time off
- Relocation assistance
- Bereavement leave
- Vision Insurance
- Discounts on extracurricular activities
- Continuing Education Reimbursement
- Relocation packages
- Attendance at nursing conferences
Part Five How Do You Become a Psychiatric Nurse Practitioner?
To become a Psychiatric Nurse Practitioner, you’ll need to complete the following steps.
Step 1: Attend Nursing School
You’ll need to earn either an ADN or a BSN from an accredited nursing program in order to take the first steps to become a registered nurse. ADN-prepared nurses will need to complete an additional step of either completing their BSN degree or entering into an accelerated RN to MSN program which will let them earn their BSN and MSN at the same time.
Step 2: Pass the NCLEX-RN
Become a Registered Nurse by passing the NCLEX examination.
Step 3: Gain Experience or Continue Your Education
Nurses can choose to gain some nursing experience before going back to school or go directly into an MSN program depending on their unique situation. Most NP programs will require a minimum of TWO years of relevant work experience.
Step 4: Graduate With Your Psychiatric Mental Health Nurse Practitioner Degree From an Accredited Nursing Program
Enter into an MSN/NP program that offers a program to become a Psychiatric Mental Health Nurse Practitioner. For tips on getting into nursing school, check out our article on What To Know About Applying to Nursing Schools.
Step 5: Become Certified
The American Nurses Credentialing Center offers the Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan) Certification (PMHNP-BC). This certification is available to APRNs that meet the following criteria.
PMHNP-BC Certification Requirements
- Current U.S. nursing license is required
- Hold a master's, postgraduate, or doctoral degree from a psychiatric-mental health nurse practitioner program accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN).
- A minimum of 500 faculty-supervised clinical hours must be included in your psychiatric-mental health nurse practitioner program.
- Three separate, comprehensive graduate-level courses in:
- Advanced physiology/pathophysiology, including general principles that apply across the life span
- Advanced health assessment, which includes assessment of all human systems, advanced assessment techniques, concepts, and approaches
- Advanced pharmacology, which includes pharmacodynamics, pharmacokinetics, and pharmacotherapeutics of all broad categories of agents
- Content in:
- Health promotion and/or maintenance
- Differential diagnosis and disease management, including the use and prescription of pharmacologic and nonpharmacologic interventions
- Clinical training in at least two psychotherapeutic treatment modalities
Additional Exam Information
- $395 examination fee. Discounts are available for members of specific nursing associations
- This certification exam is a 3-hour test consisting of 175 multiple-choice items.
- Of the 175 items, 150 are scored and 25 are used to gather statistical data on item performance for future exams.
What’s in the Exam?
- Scientific Foundation (20%)
- Advanced pathophysiology
- Advanced pharmacology (e.g., contraindications, interactions, adverse effects)
- Advanced psychopharmacology (e.g., pharmacokinetics, pharmacodynamics, EPS, NMS)
- Psychogenomics (e.g., gene-drug interactions, heritability)
- Advanced physical assessment
- Advanced Practice Skills (25%)
- Clinical interviewing (e.g., open-ended questions, nonverbal communication)
- Health promotion and disease prevention (e.g., models, strategies)
- Mental health screening tool selection and interpretation (e.g., PHQ-9, GAD-7, Vanderbilt ADHD)
- Mental status exam
- Psychiatric emergency management (e.g., suicidal ideation, homicidal ideation)
- Psychoeducation (e.g., presentation method, topic selection)
- Recovery and resilience promotion
- Risk assessment
- Substance use screening tool selection and interpretation (e.g., COWS, CIWAS)
- Diagnosis and Treatment (25%)
- DSM-5 diagnostic criteria
- Complementary and alternative treatments
- Diagnostic and laboratory tests selection and interpretation
- Diagnostic impression
- Differential diagnosis
- Evidence-based practice (e.g., medication dosing, off-label use, psychotherapy selection)
- Psychopharmacotherapeutic management (e.g., selection, monitoring)
- Pharmacotherapeutic management (e.g., selection, monitoring)
- Psychotherapy and Related Theories (15%)
- Psychotherapy principles (e.g., cognitive, grief and loss)
- Change theories (e.g., Transtheoretical Model, motivational interviewing)
- Developmental theories
- Family theories (e.g., structural, narrative)
- Therapeutic alliance development and management (e.g., empathy, boundaries, psychotherapy facilitation, trauma-informed approach)
- Ethical and Legal Principles (15%)
- Patient's Bill of Rights (e.g., informed consent, treatment options)
- Scope of confidentiality (e.g., release of information, duty to warn)
- ANA Scope and Standards of Practice: Psychiatric-Mental Health Nursing(e.g., Psychiatric-Mental Health Nursing role, collaboration, leadership)
- Cultural and spiritual competence (e.g., special populations, risk factors, barriers)
- Ethics in clinical decision making (e.g., involuntary treatment, least restrictive care)
- Patient advocacy (e.g., educational accommodations, disabilities accommodations, FMLA)
Step 6: Get a Job as a Psychiatric Nurse Practitioner
Now you’re ready to start working as a Psychiatric Nurse Practitioner!
Part Six Top Psychiatric Nurse Practitioner Programs
We’ve rounded up some of the top Psychiatric Nurse Practitioner programs, also called Psychiatric Mental Health Nurse Practitioner (PMHNP) programs. Below are five of the top programs available for getting your PMHNP education. Check out our article on the Top 10 Psychiatric Nurse Practitioner Programs in 2020 for the full list and more information.
Part Seven What are the Continuing Education Requirements for Psychiatric Nurse Practitioners?
CEU hours will vary based on the state of licensure. For each state an individual is licensed, CEU hours will be required. Generally, NPs are required a minimum of 75 contact hours of continuing education in the specialty area (psychiatric nursing).
Additionally, even though they are functioning in an APRN role, they must maintain their RN certification. In order for an individual to renew their RN license, they will need to fill out an application, complete a specific number of CEU hours, and pay a nominal fee. Each state has specific requirements and it is important to check with the board of nursing prior to applying for license renewal.
A detailed look at Continuing Nurse Education hours can be found here.
Part Eight What is the Career Outlook for a Psychiatric Nurse Practitioner?
According to the U.S. Bureau of Labor Statistics (BLS), the career outlook for NPs is excellent. As of 2018, there were 189,100 Nurse Practitioners in the United States, while in 2028 there is an expected need of 242,400 providers. This is a 28% growth.
The American Association of Nurse Practitioners estimates that there are approximately 12,690 NPs certified in psychiatric mental health. As mental health disorders continue to rise in the United States, Psychiatric Mental Health NPs are continued to be needed. The Health Resources & Services Administration found that between the years 2016 and 2030 the national supply of psychiatric NPs is projected to grow by 6,690 FTEs.
Part Nine Where Can I Learn More About Becoming a Psychiatric Nurse Practitioner?
- 10 Top Psychiatric Nurse Practitioner Programs 2020
- Psychiatric Nurse Guide
- American Psychiatric Nurses Association
- American Association of Nurse Practitioners
- American Nurses Association (ANA)
- Foundations for Addictions Nursing (FAN)
- International Society of Psychiatric-Mental Health Nurses (ISPN)
Part Ten Other Nurse Practitioner Specialties
- General Nurse Practitioner
- Family Nurse Practitioner
- Pediatric Nurse Practitioner
- Acute Care Nurse Practitioner
- Neonatal Nurse Practitioner
- Women's Health Nurse Practitioner
- Orthopedic Nurse Practitioner
- Emergency Nurse Practitioner
- Adult-Gerontology Nurse Practitioner
Part Eleven Psychiatric NP FAQs
How long does it take to become a Psychiatric Nurse Practitioner?
- There are numerous steps to becoming a Psychiatric Mental Health NP. Typically, from the start of undergraduate education to the completion of an Advanced Practice NP degree, an individual can expect it to take a minimum of 10 years. Earning a BSN is roughly four years from start to finish. Gaining relevant bedside experience is essential prior to starting a nurse practitioner program. Most programs want a minimum of two years of experience. An NP program typically takes three years to complete.
What can you do as a Psychiatric Nurse Practitioner?
- Psychiatric NPs assess and diagnose patients suffering from mental illnesses, disorders, and substance abuse problems. They are involved in psychotherapy, can prescribe medication, educate patients and families about their diagnosis, and manage their treatment plans. PMHNP can expect to treat patients suffering from the following conditions: anxiety, depression, bipolar disorder, substance abuse, PTSD, obsessive-compulsive disorder, eating disorders, and personality disorders.
How much do Psychiatric Nurse Practitioners make?
- According to Payscale.com, Psychiatric Mental Health NPs make on average $107,309.
What is the difference between a Psychiatrist and a Psychiatric Nurse Practitioner?
- A psychiatrist is a physician that attended medical school and completed a fellowship in psychiatry. A Psychiatric Nurse Practitioner or PMHNP is an advanced practice nurse that has completed an advanced nursing program specializing in psychiatry.